Hypothermia of Some Benefit to Neonates With Encephalopathy

Altered Neural Activation in Children Exposed to Fetal Alcohol
Altered Neural Activation in Children Exposed to Fetal Alcohol
For infants with neonatal hypoxic-ischemic encephalopathy, undergoing whole-body hypothermia results in lower mortality rates as well as a nonsignificant reduction in the combined end point of death or an IQ score of

(HealthDay News) – For infants with neonatal hypoxic-ischemic encephalopathy, undergoing whole-body hypothermia results in lower mortality rates as well as a nonsignificant reduction in the combined end point of death or an IQ score of <70 at age 6–7 years, compared with usual care.

Seetha Shankaran, MD, from Wayne State University in Detroit, and colleagues reviewed long-term outcomes of a randomized trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy. Infants with moderate or severe encephalopathy were assigned to usual care (control group; 93 children) or whole-body cooling followed by slow rewarming (hypothermia group; 97 children). Cognitive, attention and executive, visuospatial, and neurologic function were evaluated, and physical and psychosocial health were assessed.

The researchers found that death or an IQ score <70 occurred in 47% of children in the hypothermia group and 62% of those in the control group (P=0.06); death occurred in 28 and 44%, respectively (P=0.04), and death or severe disability occurred in 41 and 60%, respectively (P=0.03). Moderate or severe disability occurred in 35% of 69 children in the hypothermia group and 38% of the 50 controls (P=0.87). Attention-executive dysfunction occurred in 4 and 13% of the hypothermia and usual-care groups (P=0.19), respectively, and visuospatial dysfunction occurred in 4 and 3%, respectively (P=0.8).

“In summary, whole-body hypothermia did not significantly reduce the rate of a composite end point of death or an IQ score <70 at 6–7 years of age,” the authors write. “However, hypothermia resulted in lower death rates and did not increase rates of severe disability among survivors.”

One author disclosed a financial relationship with MedImmune.

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